Flow-Diverting Devices in the Treatment of Vertebral Artery Aneurysms: Insights into Efficacy and Safety from a Systematic Review and Meta-analysis

The objective of this study is to conduct a systematic review and meta-analysis aimed at evaluating the efficacy and safety of flow-diverting devices (FDs) treatment for intracranial vertebral artery (VA) aneurysms. We searched PubMed, Web of Science, OVID, and Embase for English-language studies up to February 2024 and included clinical studies on FD treatment of intracranial VA aneurysms. Sensitivity analysis evaluated outcome stability. Of 2273 articles, 29 studies involving 541 aneurysms treated with FDs were included. Based on the Methodological Index for Non-Randomized Studies (MINORS), six were high-quality and 23 moderate quality. FD treatment showed a 95% rate of favorable clinical outcomes (95% CI, 89 –99%), 81% (95% CI, 74–88%) complete aneurysmal occlusion, 4% (95% CI, 2–7%) ischemic complication incidence, 1% (95% CI, 0–3%) hemorrhagic complication incidence, 95% (95% CI, 87–100%) posterior inferior cerebellar artery (PICA) preservation, and 6% (95% CI, 3–10%) in-stent stenosis or occlusion across clinical and angiographic follow-up periods of 13.62 months (95% CI, 10.72–16.52) and 11.85 months (95% CI, 9.36–14.33), respectively. Subgroup analyses, based on a 12-month angiographic follow-up threshold, indicated no statistically significant differences in rates of comple te aneurysm occlusion, PICA preservation, or in-stent stenosis or occlusion incidence (p >  0.05) between subgroups. Moreover, significant differences were observed in cli...
Source: Translational Stroke Research - Category: Neurology Source Type: research